Senior Insurance Collections Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead and provide support to the insurance collections team in managing accounts receivable.

• Ensure the timely and accurate resolution of insurance claims, including denial management and tracking underpayment trends.

• Act as a subject matter expert and handle first-level escalations.

• Optimize workflows and mentor team members effectively.

• Address complex claims and payer-related issues.

• Engage in training, audits, reporting, and initiatives aimed at process improvement.

• Collaborate closely with management to support strategic goals of revenue cycle management and ensure compliance with policy updates.

• Provide liaison services between healthcare providers, patients or responsible parties, and revenue sources.

• Maintain ongoing communication with insurance carriers and third-party payers until accounts are settled.

• Negotiate payments for current and past-due accounts through phone calls and written correspondence.

• Update patient account details as necessary.

• Monitor and identify trends in payer denials and problematic accounts; communicate findings to the supervisor.

• Generate monthly aging reports based on service dates and current accounts receivable.

• Manage daily assigned insurance worklists.

• Employ collection techniques to resolve accounts in accordance with company policies and procedures.

• Report coding-related denials to the Coding Specialist.

• Fax necessary information, generate retroactive authorization requests, and verify medical eligibility.

• Research claims to ensure appropriate reimbursement.

• Assist with special projects as assigned by the Billing Manager or Supervisor.

⛳️ Requirements

• Experience working in a large, expanding healthcare organization supporting 100 or more providers and managing a team of over 10 members.

• Minimum of 3 years’ experience in insurance collections.

• Familiarity with large healthcare billing systems (involving more than 100 providers) is advantageous.

• Understanding of medical terminology used in medical collections and billing (CPT, ICD-10, HCPCS).

• Knowledge of appeal letters.

• Intermediate proficiency in Microsoft Excel and Office products is essential.

• Experience with HMO, PPO, and Medicare insurances.

• Over 5 years’ experience in the healthcare industry.

• At least 1 year of supervisory experience or leading a team in healthcare revenue management cycle roles that cover all phases of revenue cycle management.

• Ability to read, interpret, and apply regulations, policies, and procedures.

🏝️ Benefits

• Exceptional work/life balance.

• No weekends or evenings required – Monday through Friday schedule.

• Paid holidays and vacation time.

• Opportunities for professional advancement.

• Competitive salary.

• Medical insurance.

• Dental coverage.

• Vision insurance.

• Spending accounts.

• Life and AD&D insurance.

• Disability coverage.

• Accident insurance.

• Critical illness insurance.

• Hospital indemnity insurance.

• Legal assistance.

• Identity theft protection.

• Pet insurance.

• 401(k) retirement plan with Non-Elective Safe Harbor employer contributions for eligible employees.

• Discretionary profit-sharing with employer contributions ranging from 0% to 4% for eligible employees.

• Discounts on concerts, travel, movies, and more through Tickets at Work.